ArticleMedical care2011
Race and timeliness of transfer for revascularization in patients with acute myocardial infarction.
Article in Medical care, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Missed Connection: A Case of Inadequate ECG Oversight in Cardiac Surgery.AHRQ WebM&M : morbidity & mortality rounds on the Web · 2024Article
- Impact of a Comprehensive ST-Segment-Elevation Myocardial Infarction Protocol on Key Process Metrics in Black Americans.Journal of the American Heart Association · 2023Article
- A Conceptual Framework for Optimizing the Equity of Hospital-Based Emergency Care: The Structure of Hospital Transfer Networks.The Milbank quarterly · 2023Article
- Racial Diversity Among American Cardiologists: Implications for the Past, Present, and Future.Circulation · 2021Article
- Association of insurance status with potentially avoidable transfers to an academic emergency department: A retrospective observational study.Journal of the American College of Emergency Physicians open · 2021Article
- Racial/Ethnic Disparities in Interhospital Transfer for Conditions With a Mortality Benefit to Transfer Among Patients With Medicare.JAMA network open · 2021Article
- Identifying Racial/Ethnic Disparities in Interhospital Transfer: an Observational Study.Journal of general internal medicine · 2020Observational
- Ethnic and Racial Disparities in Acute Myocardial Infarction.Current cardiology reports · 2020Review
- Article
- Understanding Why Black Patients Have Worse Coronary Heart Disease Outcomes: Does the Answer Lie in Knowing Where Patients Seek Care?Journal of the American Heart Association · 2019Article
- Independent Predictors of Late Presentation in Patients with ST-Segment Elevation Myocardial Infarction.Arquivos brasileiros de cardiologia · 2018Article
- Disparities in Knee and Hip Arthroplasty Outcomes: an Observational Analysis of the ACS-NSQIP Clinical Registry.Journal of racial and ethnic health disparities · 2018Article
- Interhospital Facility Transfers in the United States: A Nationwide Outcomes Study.Journal of patient safety · 2017Article
- Racial and Ethnic Differences in End-of-Life Medicare Expenditures.Journal of the American Geriatrics Society · 2016Article
- Racial and Ethnic Differences in Acute Coronary Syndrome and Myocardial Infarction Within the United States: From Demographics to Outcomes.Clinical cardiology · 2016Review
- Population-level differences in revascularization treatment and outcomes among various United States subpopulations.World journal of cardiology · 2016Review
- Insurance status and the transfer of hospitalized patients: an observational study.Annals of internal medicine · 2014Observational
- The current state of ethnic and racial disparities in cardiovascular care: lessons from the past and opportunities for the future.Current cardiology reports · 2014Review
- Using existing data to address important clinical questions in critical care.Critical care medicine · 2013Review
- Racial disparities in the use of cardiac revascularization: does local hospital capacity matter?PloS one · 2013Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesPatients with acute myocardial infarction (AMI) who are admitted to hospitals without coronary revascularization are frequently transferred to hospitals with this capability. We sought to determine whether the timeliness of hospital transfer and quality of destination hospitals differed between black and white patients.
methodsWe evaluated all white and black Medicare beneficiaries admitted with AMI at nonrevascularization hospitals in 2006 who were transferred to a revascularization hospital. We compared hospital length of stay before transfer and the transfer destination's 30-day risk-standardized mortality rate for AMI between black and white patients. We used hierarchical regression to adjust for patient characteristics and examine within and across-hospital effects of race on 30-day mortality and length of stay before transfer.
resultsA total of 25,947 (42%) white and 2345 (37%) black patients with AMI were transferred from 857 urban and 774 rural nonrevascularization hospitals to 928 revascularization hospitals. Median (interquartile range) length of stay before transfer was 1 day (1 to 3 d) for white patients and 2 days (1 to 4 d) for black patients (P<0.001). In adjusted models, black patients tended to be transferred more slowly than white patients, a finding because of both across and within-hospital effects. For example, within a given urban hospital, black patients were transferred an additional 0.24 days (95% confidence interval 0.03-0.44 d) later than white patients. In addition, the lengths of stay before transfer for all patients at urban hospitals increased by 0.37 days (95% confidence interval 0.28-0.47 d) for every 20% increase in the proportion of AMI patients who were black. These results were attenuated in rural hospitals. The risk-standardized mortality rate of the revascularization hospital to which patients were ultimately sent did not differ between black and white patients.
conclusionsBlack patients are transferred more slowly to revascularization hospitals after AMI than white patients, resulting from both less timely transfers within hospitals and admission to hospitals with greater delays in transfer; however, 30-day mortality of the revascularization hospital to which both groups were sent to appeared similar. Race-based delays in transfer may contribute to known racial disparities in outcomes of AMI.
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